When the Fifth International Congress on AIDS in Asia and the Pacific met in Kuala Lumpur in 1999, Cambodia was one of three Asian countries reporting substantial nationwide epidemics. Prime Minister Hun Sen was sufficiently worried to write to every provincial governor to note the rapid spread of HIV and to urge support for prevention programs.
Two years later, “the picture has changed dramatically” in Cambodia and the rest of Asia, according to a report issued by the Sixth International Congress on AIDS in Asia and the Pacific, which met in Melbourne, Australia.
“What news will this conference bring? Its good news will be the emerging evidence that Cambodia is on the path to success,” Peter Piot, UNAIDS executive director, told delegates at the Oct 5 opening ceremony.
“Consider this: a society facing all its strains and pressures post-conflict, and then along comes HIV to add to the burden. But the Cambodian people responded—from the King and the prime minister down to the man and woman in the street.”
Cambodia’s success story in the regional fight against AIDS was prominently featured during the five-day conference, said government and NGO officials who attended. That Cambodia could lower the percentage of its population with HIV from 3.9 in 1997 to 2.8 in 2000 offered hope to delegates, who learned that Indonesia, Iran, Japan, Nepal, Vietnam, India and China have recorded large increases in HIV cases the last two years.
The National Center for HIV/AIDS announced in April that the number of HIV cases in Cambodia continues to drop.
Only 169,000 adults are now estimated to have the virus that causes AIDS. Officials have attributed the drop to a rise in the number of deaths from AIDS and to the success of prevention and education programs. More people are using condoms, while fewer men are visiting sex workers, studies have found.
In Melbourne, a special session about Cambodia was held. Presentations were made by commercial sex workers, by officials from NGOs and the Ministry of Health and by two generals from the Ministry of Defense, who spoke on educating soldiers about the risks of HIV. About 90 people made up Cambodia’s delegation.
“The key message we gave was that there have been no political barriers. Our culture and our religion have accepted HIV/AIDS prevention. But other countries still have those barriers,” said Dr Hor Bunleng, deputy director of the National Center for HIV/AIDS.
“Many experts believe that the HIV levels now being recorded in Cambodia and Thailand could have been much higher in the absence of strong intervention programs,” the report stated. “These two countries undertook effective prevention with good coverage of sex worker/client networks and thereby dramatically changed the course of their epidemics. “Countries that still have few HIV infections would do well to draw inspiration from these interventions rather than comfort from their currently low infection rates.”
In 1991, Thailand became the first Asian country to launch a large-scale prevention campaign. Cambodia followed in Thailand’s footsteps, implementing such programs as 100 percent usage of condoms in Sihanoukville brothels, the report stated.
Minister of Health Hong Sun Huot, however, noted that Cambodia still has the highest HIV rate in Asia. “There is a worry that donors could reduce aid because of this success,” he said.
“Maybe they would shift funds to Africa. But they have invested in Cambodia and they have seen that they can get good results.”
Hong Sun Huot said he asked Piot in Melbourne not to forget Cambodia when the UN finishes establishing its global fund to fight AIDS at the end of the year.
Officials hope the fund will directly distribute $7 billion to $10 billion each year to national programs in developing countries, said Geoff Manthey, UNAIDS country program adviser.
But he said it is too soon to know how much Cambodia will receive from the fund. “Initially, the UN was looking more to Africa. But there is a growing recognition that Asia has a potentially major epidemic,” he said.